Risk Perception and Communication in Sub-Saharan Africa

Abstract

In this narrative review, a brief summary of theoretical approaches to risk perception is followed by an analysis of some of the special factors influencing risk perception and risk communication in sub-Saharan Africa. Examples of recent and emergent local medicines and vaccine controversies in several countries are given along with evidence and analysis of how they were managed. These demonstrate, among other things, the extent to which ethnic, religious and cultural issues influence popular perception, and the power of rumour and anecdote in shaping public opinion and official responses to events. Where safety monitoring systems exist, they are in their infancy, with limited capacity for data collection, credible scientific review, effective public communication and robust crisis management. Although increasing democratic freedoms, including less restricted media, and evolving health systems are addressing the challenges and give hope for further progress, there are still deep and intractable issues that inhibit transparent and effective risk communication and stand in the way of African populations comprehending medicines and their risks in safer and more balanced ways. Some proposals for future change and action are offered, including the pursuit of a deeper understanding of local and national values, assumptions and beliefs that drive risk perception; tailoring public health planning and communications to specifically-targeted regions and populations; strengthening of safety surveillance and data-collection systems; giving higher priority to medicines safety issues in healthcare training and public education.

Health risks from environmental degradation in the Niger Delta, Nigeria

“…The study found that complacency, high levels of illiteracy, multi-ethnic diversity, limited access to main and social media (especially in rural areas), a lack of alternatives (such as economic activities, water, food, scarcity of land), emotional attachment to place, limited access to experts who were perceived to be neutral, and lack of trust between locals and government officials were some of the main barriers to risk communication in the Niger Delta. These findings are similar to the study by Dodoo and Hugman (2012) who asserted that there is limited capacity for credible and reliable scientific assessment and public communication strategies in sub-Saharan Africa. In part, this reflects the relatively low levels of scientific literacy in the region and the power gradients that exist between local communities and the corporate–government nexus.…”

“…There have, however, been very few such studies and so the use of risk communication as a potential mitigation strategy is an area that needs further attention. Dodoo and Hugman (2012) identified several factors impeding effective risk communication in sub-Saharan Africa including limited ability to collect useful data, few credible and reliable scientific assessment practices, and few robust risk management and public communication strategies. When considering the role of the media in such situations, Edafienene (2012) found that the media had little or no influence on risk-related policy decisions in the Niger Delta.…”

The contribution of Ghanaian patients to the reporting of adverse drug reactions: a quantitative and qualitative study

“…Moreover, there are differences in levels of education, culture and living conditions amongst people in Ghana and other SSA countries compared to those living in Europe and other high-income countries. Such differences may lead to variations in knowledge and perception on medications, ADRs and ADR reporting [19, 20]. It is also of importance to know what motivates patients in Ghana to report an ADR and whether they know the formal channels for ADR reporting including direct patient reporting.…”

Focusing on Risk Communication About Medicines

“…This barrier also exists when communicating with broader audiences, and Dodoo and Hugman[24] give us important advice in this respect: public concerns have to be addressed, whether or not, as pharmacovigilance professionals, we share these concerns. The authors take us on a journey through sub-Saharan Africa, with examples illustrating how risk communication may be linked with social problems and citizens’ trust — or often mistrust — in governments.…”